ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on Twitter

Kidney Week

Abstract: TH-PO262

Delta-He It Is a Novel Biomarker of Mortality in Prevalent Hemodialysis Patients: A Multivariate Regression Predictive Model Development 

Session Information

Category: Anemia and Iron Metabolism

  • 202 Anemia and Iron Metabolism: Clinical


  • Sánchez, Manuel Benítez, Hospital Juan Ramon Jimenez, Huelva, Huelva, Spain

Delta-He is a marker of iron availability, which has been suggested as a marker of the inflammation. It is calculated as the difference between the hemoglobin content of reticulocytes (Ret-He) reflects the incorporation of iron into the erythroid progenitor cells over the previous 2–4 days, and the hemoglobin content of erythrocytes (RBC-He). Under normal conditions, Delta-He has a positive value. As iron homeostasis and inflammation are related through the action of Hepcidin, an acute inflammatory response suppresses the availability of iron to erythropoietic progenitor cells and rapidly induces a decrease in Ret-He, leading to a negative value of Delta-He.


78 patients prevalent in Hemodialysis were followed during 1 year. We have analyzed time to the event (mortality from any cause ).Has been acknowledged Mortality as Dependente Variable and Delta-He Dicotomized as independent variable. Time in Hemodialysis , KtV, the treatment with erythropoiesis-stimulating agents (ESA) and Fe iv therapy was taken into account, PCR, RET-He and Delta-He . We have realise the determinations through the Sysmex XE 500. A survival study was carried out trougt using Multivariate Regression Cox Model . The predictive model is developed with the regression coefficients. Internal validity was realise by Bootstrap. The model is presented as a nomogram.


22/78 patients (28.2%) presented exitus . 19/78 patients (24.4%) had Delta-He Negative and require a higher weekly dose of ESA. The delta He has a protective effect against mortality, that is, the greater the value of Delta-He, the less mortality, for each unit that increases Delta He above 0 the mortality decreases by 27%. Discrimination: Index C: 0.74, Calibration: I. Brier: 0.171, R2 Nagelkerke: 0.22.


Delta-He Negative is a predictive factor of all-cause mortality at one year in patients on hemodialysis, associated with inflammation and hypo-responsiveness to ESA.